O diagnóstico de Transtorno de Déficit de Atenção e Hiperatividade (TDAH) apresentou um expressivo crescimento durante a última década (LEGNANI et al., 2006), tornando-se o mais frequente dos transtornos psiquiátricos tratados em jovens (ROHDE et al., 2007). Dados epidemiológicos apontam para prevalência mundial de 4% a 10% entre crianças. Os desdobramentos dessa epidemia diagnóstica não são sem efeitos para a criança e seu corpo. Temos, do lado da família e da escola, uma criança tida como insuportável, que não para e que ninguém consegue controlar; via de regra, esta última não é escutada, mas julgada a partir de seus comportamentos. O desejo tanto do lado da escola como do da família é silenciar a criança e sua agitação. E a resposta a essa demanda vai ser encontrada junto ao saber médico-científico que, consoante à lógica do discurso capitalista de mercados, que tende a simplificar para gerir, tem uma resposta clara e objetiva: trata-se de um transtorno neurobiológico que deve ser tratado via medicação e terapia cognitivo-comportamental. Essa pesquisa tem como objetivo debater de forma crítica a homogeneização da criança sob o diagnóstico de TDAH no discurso médico-científico, trazendo rigor e formalizando a discussão, tanto no âmbito clínico, em que há uma redução do sujeito e seu sofrimento a processos neuroquímicos, como no campo político, no qual a articulação entre saber e poder, evidenciada pela medicalização da existência, permanece oculta sob o véu do discurso da neutralidade científica. A partir de recortes da experiência da clínica psicanalítica de orientação lacaniana com crianças procurou-se restaurar a complexidade da leitura da produção sintomática de um sujeito, articulando-a a um modo de gozo e ao desejo do Outro. Nesse sentido foi possível formalizar que se trata de sujeitos que, de modo singular, renunciam ao seu espaço e à apropriação/subjetivação de seu corpo para gozar e servir ao gozo ao Outro. Quando consideramos o eixo político, podemos pensar a medicalização do desvio como uma construção social que evidencia um momento singular da evolução da cultura e da função social da medicina, em que o aumento do poder médico sobre a regulação de condutas e comportamentos passa a ter uma função de normalização psíquica, constituindo um novo sintoma no laço social / The diagnosis of attention-deficit hyperactivity disorder (ADHD) has showed a significant growth over the last decade (LEGNANI et al., 2006), making it the most common psychiatric disorder treated in young people (ROHDE et al., 2007). Epidemiological data indicate a global prevalence of 4 % to 10 % among children. The consequences of this epidemic of diagnosis are not without effects on the children and their body. We have, on the side of the family and school, a child seen as \"unbearable,\" unstoppable and uncontrollable. By and large, these children are not heard, but judged from their behaviour. That which the school and the family desire is to mute this children and \"their agitation.\" And the answer to this demand will be found in the medical-scientific discourse which, in line with the logic of capitalist market discourse, which tends to simplify to manage, has a clear and objective answer: it is a neurobiological disorder that should be treated via medication and cognitive behavioural therapy. The present research aims to critically discuss the homogenization of the child under the ADHD diagnosis in the medicalscientific discourse, bringing rigor and formalizing the discussion both in the clinical setting, where the subject and his suffering are reduced to neurochemical processes, and in the political field, in which the relationship between knowledge and power, as evidenced by the medicalization of existence, remains hidden under the veil of the discourse of scientific neutrality. Based on the experience of clippings of Lacanian psychoanalytic clinical guidance with children, we sought to restore the complexity of reading a symptomatic production of a subject, linking it to a mode of enjoyment and desire of the Other. In this sense, it was possible to formalize that these subjects who, in a unique way, give up their space and the appropriation/subjectivization of their body to enjoy and serve the jouissance of the Other. In relation to the political axis, we can consider the medicalization of deviance as a social construct that reflects a unique moment in the evolution of culture and the social function of medicine, in which the increased medical power over the regulation of conduct and behaviour acquires a function of psychic standardization, thereby creating a new symptom in the social bond

The purpose of this study was to assess African American parents’ and caregivers’ perceptions about ADHD, diagnosis, treatment, and outcomes to determine if and/or how those views may affect diagnosis and treatment rates among African American youth. ADHD prevalence is increasing overall in the US across all races/ethnicities, but ADHD diagnosis and treatment rates are still low among African American youth compared to White youth. While African American youth may be more greatly affected by the disorder than White youth, there is a gap in understanding why some parents seek help for their child’s ADHD related behaviors, while others do not. African American parents and primary caregivers of boys ages 5-14 who attended an afterschool program in Harlem, New York City, participated in a cross-sectional design interview study with 43 participants. Transcripts were audio-recorded, transcribed and analyzed using an inductive approach. Highlights of findings included parents’ and caregivers’ discomfort using medication to treat ADHD, concerns about labeling/stigma and misconceptions about ADHD, diagnosis, and treatment. Implications for practice included the need for: disseminating accurate and relevant information, improving understanding about proven and promising non-pharmacological treatment methods and addressing discriminatory practices in ADHD treatment. Recommendations for research include creating and evaluating culturally sensitive treatment approaches, exploring why certain families are misinformed about ADHD, finding effective ways to correct misconceptions, and testing alternative ways to educate healthcare and education professionals on how best to work with African American and other underserved communities.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O Transtorno de DÃficit de AtenÃÃo/ Hiperatividade (TDAH) Ã um transtorno prevalente e debilitante, diagnosticado com base em persistentes nÃveis de hiperatividade, desatenÃÃo e impulsividade. FÃrmacos estimulantes tÃm sido eficazes no tratamento desse transtorno, sendo que o metilfenidato (MFD) Ã o agente terapÃutico mais prescrito e seu uso aumentou significativamente nos Ãltimos anos, entretanto, as conseqÃÃncias da sua utilizaÃÃo ainda sÃo pouco conhecidas. O MFD foi avaliado em modelos animais clÃssicos para screening de drogas com atividade em ansiedade, depressÃo e convulsÃo, tais como, labirinto em cruz elevado (LCE), campo aberto, rota rod, nado forÃado e convulsÃo induzida por pilocarpina, e em estudo neuroquÃmico, atravÃs da concentraÃÃo de monoaminas, tais como dopamina (DA), noradrenalina (NE) e 5-hidroxitriptamina (5-HT), alÃm da atividade da enzima Acetilcolinesterase (AChE). O MFD foi administrado de forma aguda em todos os testes, nas doses de 2,5; 5; 10 e 20 mg/Kg, atravÃs da via oral (v.o.) em camundongos jovens (21 dias) e adultos. Os resultados mostraram que o MFD apresentou efeito ansiolÃtico nos modelos LCE, pois aumentou todos os parÃmetros analisados no LCE, como NEBA, PEBA, TPBA e PTBA nas doses de 10 e 20mg/Kg nos animais jovens e apenas na de 20mg/Kg nos animais adultos. No teste do campo aberto, foi observado aumento na atividade locomotora em todas as doses nos animais jovens e apenas nas doses maiores (10 e 20mg/Kg) nos animais adultos. NÃo alterou o nÃmero de grooming e rearing. O MFD apresentou efeito antidepressivo no Sistema Nervoso Central (SNC), pois no teste do nado forÃado diminuiu o tempo de imobilidade nas doses de 10 e 20 mg/Kg nos animais jovens e apenas na dose de 20mg/Kg nos animais adultos. A avaliaÃÃo neuroquÃmica comprovou o efeito antidepressivo do MFD, pois se verificou um aumento da concentraÃÃo das monoaminas. No teste da convulsÃo induzida por pilocarpina, o metilfenidato diminuiu a latÃncia de convulsÃo, bem como a latÃncia de morte nos animais jovens e adultos, sugerindo que o MFD apresenta atividade proconvulsivante. O estudo sobre os efeitos sobre o sistema de neurotransmissÃo colinÃrgica demonstrou que o prÃ-tratamento com MFD reduziu a atividade da AChE apenas no corpo estriado. Em conclusÃo, esses efeitos mostraram que o MFD apresenta efeito ansiolÃtico, efeito antidepressivo e atividade proconvulsivante. / Attention-deficit hyperactivity disorder (ADHD) is a prevalent and debilitating disorder diagnosed on the basis in persistent levels of overactivity, inattention and impulsivity. Stimulant drugs have been effective in treating this disorder, and methylphenidate (MPH) is the most widely prescribed therapeutic agent and its use has increased significantly in recent years, however, the consequences of its use are still poorly known. The MFD was assessed in classical animal models to the screening of drugs with activity in anxiety, depression and convulsion, such as elevated plus maze (EPM), open field, rota rod, forced swimming and pilocarpine-induced seizures and a neurochemistry study, through the level of monoamines, such as dopamine (DA), norepinephrine (NE) and 5-hidroxytriptamine (5-HT) but the activity of the enzyme acetylcholinesterase (AChE). The MPH was administered acutely in all tests at doses of 2,5; 5; 10 e 20 mg/Kg, through the oral via (p.o.) in young mice (21 days) and adults. Results showed that the MPH presented an anxyolitic effects in the models of EPM, since increased all the parameters analyzed in the EPM, such as NEOA, PEOA, TPOA, PTOA, at doses of 10 and 20 mg/Kg in young animals, and only in animals of 20 mg/Kg in adults. In the open field, we observed an increase in locomotor activity at all doses in young animals and only at higher doses (10 e 20 mg/Kg) in adult animals. Not was observed no alteration the number of rearing and grooming. MPH presented antidepressant effect of Central Nervous System (CNS), since in the forced swimming, decreases the time of immobility in doses of 10 and 20 mg/Kg in young animals and only at a dose of 20 mg/Kg in adult animals. The neurochemistry evaluation comproved the antidepressant effect do MPH, because there was an increased concentration of monoamines. The test of the seizure by pilocarpine, MPH did decrease the latency of convulsion and latency of death in young and adult animals, suggesting that the MPH has proconvulsivante activity. The study of the effects of the cholinergic neurotransmission system has show that pretreatment with MPH reduced AChE activity only in the striatum. In conclusion, these effects showed that MPH presented anxiolitic effect, antidepressant effect and proconvulsivante activity.

O TDAH é um fenômeno de entendimento complexo e muitas vezes controverso, possuindo sintomas que, em certo grau, estão presentes em crianças de diferentes idades e contextos, reforçando a necessidade de pensar essa manifestação a partir de teorias que reflitam sobre o desenvolvimento da criança. Em estudo anterior (Folquitto, 2009), investigou-se o desenvolvimento de crianças diagnosticadas com TDAH. Os resultados sugeriram indícios de defasagens no desenvolvimento, e não foram observadas diferenças significantes no desempenho entre grupos de crianças com TDAH, fazendo ou não uso de medicamentos, durante a aplicação de provas piagetianas. Procurou-se, na presente pesquisa, elaborar estratégias de intervenção que possibilitem às crianças avançar em seu desenvolvimento, a partir da construção de novos procedimentos que conduzirão, progressivamente, a estruturações mais avançadas de pensamento. A hipótese foi verificar se é possível proporcionar, com base na teoria piagetiana, experiências facilitadoras para a construção de capacidades cognitivas e afetivas que favoreçam o desenvolvimento dessas crianças, bem como investigar suas crenças espontâneas sobre o tempo. Foi conduzido um estudo longitudinal, durante 12 meses, com intervenções utilizando jogos e situações problema, estimulando reflexões, aquisição de conhecimentos significativos, favorecendo a construção de procedimentos e consciência das ações. A mediação realizada pelos profissionais foi a principal estratégia de intervenção adotada, com o intuito de mobilizar processos de autorregulação nas crianças. Participaram da pesquisa 18 crianças, com idades entre 7 a 12 anos. Anteriormente, e posteriormente à intervenção, os participantes e seus pais foram entrevistados, para avaliação do desenvolvimento das noções operatórias, medidas neuropsicológicas e sintomas de TDAH. Foram utilizados os seguintes instrumentos: SNAP-IV, WISC-III (subtestes Vocabulário, Cubos, Código, Dígitos e Procurar Símbolos), Figura de Rey, e as seguintes provas piagetianas: Conservação das quantidades discretas, Mudança de critério/dicotomia, Noção de ponto e contínuo, O relacionamento das perspectivas, Sucessão dos Acontecimentos Percebidos, Simultaneidade e O tempo da ação própria e a duração interior. Perguntou-se também às crianças o que era o tempo, solicitando exemplos. Os participantes foram subdivididos em um grupo intervenção, que participou das atividades propostas (n=13), e grupo comparação (n=5). Foi escolhida a estratégia de composição dos grupos a partir de uma amostra definida por conveniência. Para o grupo intervenção, houve diferença estatisticamente significativa, na comparação entre as avaliações anterior e posterior à intervenção, em relação aos sintomas, QI, velocidade de processamento e funções executivas. Comparando-se os dois momentos, houve diferença significativa para as respostas das provas piagetianas como um todo (p=0,011), O relacionamento das perspectivas (p=0,024) e Simultaneidade (p=0,023). O grupo comparação não apresentou diferença estatisticamente significativa no desempenho nas avaliações, para as medidas analisadas. Sobre as crenças espontâneas sobre o tempo, constatou-se que a maioria das crianças conceituou o tempo como vinculado à própria ação, desconsiderando aspectos como a sucessão dos movimentos e a sensação de passagem do tempo. Os resultados indicam que as intervenções com jogos, em grupo e mediadas por profissionais, podem mobilizar o desenvolvimento de crianças com TDAH, diminuindo sintomas e melhorando suas funções executivas, e, principalmente, tais resultados demonstram que o método de intervenção realizado, pautado na utilização de jogos mediada por profissionais, foi efetivo para mobilizar processos de autorregulação e tomada de consciência por parte dos participantes, que assim puderam avançar em seu desenvolvimento, construindo procedimentos de melhor qualidade e estruturações cognitivas e afetivas mais adaptadas. Portanto, os resultados obtidos podem ser interpretados como um indício de que propostas de intervenções em longo prazo, envolvendo situações problema, reflexões sobre as ações e tomada de consciência, são fundamentais para que crianças com TDAH possam ter processos de aprendizagem e desenvolvimento mais significativos / ADHD is a complex disorder, whose understanding is often controversial. ADHD symptoms, to some degree, are present in children with different ages and backgrounds, reinforcing the need to study this phenomenon from a theoretical perspective that considers the development of children. In a previous study (Folquitto, 2009), it was investigated the development of children diagnosed with ADHD. They were also evaluated according to whether use psycho stimulant medications or not. Comparing subgroups, no significant differences were observed, indicating that the use of these medications has not contributed sufficiently to favour the development of ADHD children. In the present research, we aimed at developing intervention strategies that could enable children to enhance development, constructing new procedures who lead, progressively, to more advanced structures of thinking. The hypothesis of this work was to investigate if it is possible to provide, based on the Piagetian theory, experiences that facilitate the construction of cognitive and affective capacities that would favour the development of these children, as well as to investigate their spontaneous beliefs about time. This is a longitudinal study, performing interventions with games and problem-solving situations that stimulate children to analyse their activities and to acquire meaningful knowledge, favouring the construction of new procedures, awareness of actions and cognitive structuring. Participants were 18 children, aged 7-12 years old. Previously, and after the intervention, participants and their parents were interviewed to assess the development of operational notions, neuropsychological measures of Executive Functions and ADHD symptoms. We used the following instruments: SNAP-IV, WISC-III´s subtests \"Vocabulary\", \"Block Design\", \"Coding\", \"Digit Span\" and \"Symbol Search\", Rey Osterrieth Complex Figure (ROCF), and the Piagetian tasks Conservation of discrete quantities; Change of criteria - dichotomy; the tasks Three mountains, Succession of Events Perceived, The ideia of points and the ideia of continuity, Simultaneity, and The time of the action and the internal duration.Participants were divided into an experimental group, who took part in the intervention (n=13), and a control group (n=5), composed by ADHD children who did not take part in the intervention program. For the intervention group there were statistically significant differences when comparing the assessments before and after the intervention for symptoms, IQ, processing speed and executive functions. Comparing the two periods, there was significant difference in the responses of piagetian tasks as a whole (p=0.011), the Three mountains task (p=0.024) and Simultaneity (p=0.023). The comparison group showed no statistically significant difference in the performance evaluations for the measures analyzed. Regarding spontaneous beliefs about time, the majority of children conceptualized time as linked with action itself, not considering aspects like the succession of movements and sensation of time going by. Results indicate that interventions with games, mediated by professionals, can be useful tools to assist and enhance the development of children with ADHD, decreasing symptoms and improving executive functions. Specially, this results demonstrate that intervention method performed, based on use of games mediated by professionals, was effective in mobilizing self-regulation and awareness processes by participants. Thus, they were able to move forward in its development, building better procedures and affective and cognitive structuring more adapted. Results presented can be interpreted as an indication that long-term interventions, involving problem solving situations, reflections on the actions and awareness are fundamental to enable children with ADHD to have more meaningful learning processes and developing

Nos dias atuais, uma atenção que não seja seletiva, focal, sustentada e voluntária é tratada como desatenção. Neste contexto, a hipercinesia do corpo é entendida, muitas vezes, como um sintoma passível de medicalização. Mas existe uma relação direta entre a quietude do corpo e o estar atento do sujeito? Na busca por respostas para este e outros questionamentos, foi realizada uma pesquisa de campo onde se observou a dinâmica de um grupo de crianças no ambiente escolar, nos seus dois primeiros anos do Ensino Fundamental de nove anos. O material empírico compôs-se de registros realizados durante os anos de 2006 e 2007, através de caderno de campo, fotografias, filmagens, entrevistas semi-estruturadas com pais, educadores e crianças, bem como análise de documentos escolares, a fim de poder relacionar dinâmica corporal e o funcionamento da atenção de um grupo de crianças em diferentes atividades. A análise dos dados foi realizada apoiada na perspectiva teóricometodológica proposta pela Rede de Significações - RedSig (2004) e a mulher rendeira, suas almofadas, alfinetes, linhas e bilros foram as metáforas usadas para descrever o percurso metodológico. Assim sendo, foi na relação entre “pesquisadora-rendeira” e seus bilros (crianças, educadoras, pais e contextos) que esta pesquisa aconteceu, ou numa outra escrita, se fizeram os fios para a tecitura desta renda de bilros. Buscou-se assim, com os fios encontrados, tecer por meio destes corpos/ sujeitos e que agora se fazem bilro, uma renda de relações que possibilitasse um outro olhar sobre o corpo e sua motricidade no estar atento da criança em diferentes atividades. Esta pesquisa aponta para o fato de que “atenção” é uma palavra com muitos significados e também que o que se entende por atenção, pode ser diferente do que se percebe no sujeito atento. E propõe também a existência de duas manifestações involuntárias na dinâmica do corpo, que podem sugerir um estar atento à tarefa ou situação, são elas: o tônus atencional e as sincinesias. Lembramos, no entanto, que estas (in)conclusões surgiram à partir da convivência com muitos sujeitos, em diferentes contextos. E também, que o que se fez aqui não foi uma correlação direta entre símbolo e significado, pois acreditamos que o linguajar do corpo se faz na relação com o outro. / Nowadays, an attention which is not selective, focal, sustained and voluntary is deemed as inattention. In this context the body hyperkinesis is understood, many times, as a symptom susceptible to medicalization. Is there a direct connection between the body quietude and the ‘be attentive’ state of the subject? In search for answers for this and other questions, a field survey was done where the corporal dynamics of a group of children in the school environment was observed in the first two years out of nine of the Elementary School. The empirical material is constituted of registrations done during the years of 2006 and 2007, through a field registration book, photos, video recordings, a semi-structured interview with parents, educators and children, as well as school documents analysis with the intention to be able to relate the corporal dynamics and the attention functioning of a group of children in different activities. The data analysis was done supported in the theory-methodology perspective proposed by the Rede de Significações – RedSig (2004) and the lacemaker, her cushions, pins, threads and bobbin laces were the metaphors used to describe the methodological route. Therefore, it was in the relation between “surveyor-lacemaker” and her bobbin laces (children, educators, parents and contexts) that this survey took place, or in other words, the threads were made for the braiding of this bobbin lace. The endeavour was to, with the threads found, braid through these bodies/subjects that now are turned into bobbin laces, a lace of relations that make possible a new view about the body and its motricity in the being attentive of a child in different activities. The survey indicated the fact that “attention” is a word with many meanings and also what is understood as attention may be different from what is perceived in the ‘be attentive’ state of the subject. It also proposes the existence of two involuntary manifestations in the body dynamics, that might suggest a state of being attentive to the task or situation which are: the attentional tonus and the synkinesis. Reminding although that these (in)conclusiveness came from the closeness with many subjects in different contexts. Also, what was done here was not a direct correlation between symbol and meaning, because we believe the body language is done in relation with the other.

It is increasingly recognised that the broadly defined behavioural phenotype of attention deficit – hyperactivity disorder (ADHD) is a heterogeneous condition and that this heterogeneity is seen across all levels of analysis from the genetic and environmental causes to the associated neuropsychological deficits, the clinical presentation and response to treatment. This work investigated whether the more restrictive and clinically homogeneous hyperkinetic disorder (HKD) phenotype is associated with reduced neuropsychological heterogeneity compared with the broader ADHD phenotype. Using a well known, broad based battery of neuropsychological tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB) and a computerised Go/NoGo task in a large well described group of boys with rigorously diagnosed HKD who were stimulant medication naïve at baseline, it was demonstrated that the neuropsychological heterogeneity in the HKD boys was very similar to that seen previously in children with ADHD. Interestingly, and contrary to popular opinion, the strongest associations were with more simple recognition memory tasks with a low executive demand. Although there were significant associations between HKD and deficits on a range of tasks with high executive demands these were less strong. Could this neuropsychological heterogeneity be a function of different developmental issues or comorbidity? With respect to development there was evidence that boys with HKD lagged behind the healthy boys with respect to the development of their neuropsychological performance. However the pattern of development was similar with the performance of the HKD boys paralleling that of the healthy boys, suggesting that the neuropsychological heterogeneity seen in HKD is not accounted for by developmental issues. With respect to the relationship between neuropsychological functioning and comorbidity, the impact of comorbid oppositional defiant disorder (ODD) and conductdisorder (CD), it was found that all three clinical groups (pure HKD, HKD + ODD and HKD + CD) demonstrated deficits on several tasks compared with the healthy boys. Compared with healthy boys each of the three clinical groups was associated with at least one unique neuropsychological deficit. This suggests that comorbidity between HKD and both ODD and CD may contribute to the neuropsychological heterogeneity in the HKD boys. Is there an association between clinical and neuropsychological responses to the treatment of HKD with the stimulant drug methylphenidate (MPH)? Detailed analyses were conducted to investigate heterogeneity of clinical and neuropsychological response in these boys to MPH. As predicted in previous studies there is evidence for clinical heterogeneity in response with between 68 and 78% of boys with HKD responding to MPH treatment at either one or both of the doses. The precise proportion responding was dependent on the scale and definition of response used. Clinical response was not predicted by age but was predicted to a degree by severity of symptoms at baseline and it was generally true that better response was predicted by lower (better) scores at baseline. Baseline performance on a component reflecting recognition memory performance at baseline predicted clinical response to the lower (0.3 mg/kg/dose), but not the higher (0.6, mg/kg/dose) dose of MPH with poorer baseline neuropsychological performance predicting a better clinical response. Whilst there was improvement on some neuropsychological measures following administration of MPH there was little association between clinical and neuropsychological responses to medication. Clinical response was only associated with neuropsychological response on a single measure from a single task (Go/NoGo Block 2 Errors to Distractors), a task that did not itself discriminate between the HKD boys and healthy Controls at baseline.

Thesis (M.A. (Psychology)) --University of Limpopo, 2004. / The purpose of this study was to investigate whether poor motor skills are associated with ADHD. Afrikaans speaking primary school children were screened for ADHD with the Disruptive Behaviour Disorder scale (DBD). They were matched for gender and age with a normal group without ADHD symptoms. The children (31 ADHD and 31 Controls) were assessed for fine motor skills on three instruments: the Grooved pegboard, Maze co­ ordination and Finger tapping tests. To some degree all three tests of fine motor skills revealed poorer performances in the ADHD group than in the normal group. The finger­ tapping test showed the least discrimination between the groups. The girls performed significantly poorer on all tests. There were statistically significant effects of hand dominance. Results show that tests for fine motor skills discriminate between children with ADHD and normal comparisons. These results appear to support the hypothesis that poor motor skills are associated with ADHD.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent and impairing childhood disorders (5%; American Psychiatric Association, 2013), yet it is often studied in isolation. Such an approach is at odds with the clinical reality, where ADHD has a high comorbidity with oppositional defiant disorder, anxiety, and depression (Jensen, Martin, & Cantwell, 1997). Based on the possible presentations of ADHD with both externalizing and internalizing symptoms, there may be differences in associated characteristics, areas of impairment, and resulting assessment interventions. Therefore, the present study investigated how ADHD comorbidities manifested in a population of 233 elementary age children and how these profiles varied in already established characteristics (i.e., traits, social behaviors) and areas of deficit for children with ADHD (i.e., social functioning, academics, narrative comprehension). Characteristics and outcomes were examined using rating scales, behavior observations, laboratory tasks, and grades. Based on latent profile analyses, different patterns of comorbidity were identified using both parent and teacher ratings of ADHD. Based on parent and teacher report, those with high ADHD/ODD symptoms had more negative characteristics and outcomes. Network analyses corroborated these results, showing that internalizing symptoms were less relevant for associated characteristics and outcomes compared to ADHD and ODD symptoms. Overall, these results suggest that ADHD comorbidities may be primarily driven by ADHD and ODD symptoms, with this profile displaying more severe negative characteristics and outcomes.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by difficulty paying attention, impulsivity, and hyperactivity. Diagnosis of ADHD rose 42% from 2003–2004 to 2011–2012. In 2011, 3.5 million children were treated with drugs. Optimizing therapy can take a year, and may not be completely effective. A clinical trial is currently being conducted of a device/drug combination using the computer game Minecraft, to determine how certain activities affect executive function, working memory, and restraint in patients diagnosed with ADHD. The human subjects’ responses are being modeled using artificial neural networks (ANNs), an artificial intelligence method that can be utilized to interpret highly complex data. We propose using ANNs to optimize drug and Minecraft therapy for individual patients based on the initial NICHQ Vanderbilt assessment scores. We are applying ANNs in the development of computational models for executive function deficiencies in ADHD. These models will then be used to develop a therapeutic video game as a drug/device combination with stimulants for the treatment of ADHD symptoms in Fragile X Syndrome. As a first step towards the design of virtual subjects with executive function deficits, computational models of the core executive functions working memory and fluid intelligence were constructed. These models were combined to create healthy control and executive function-deficient virtual subjects, who performed a Time Management task simulation that required the use of their executive functions to complete. The preliminary working memory model utilized a convolutional neural network to identify handwritten digits from the MNIST dataset, and the fluid intelligence model utilized a basic recurrent neural network to produce sequences of integers in the range 1-9 that can be multiplied together to produce the number 12. A simplified Impulsivity function was also included in the virtual subject as a first step towards the future inclusion of the core executive function inhibition.

Multisensory environments facilitate behavioral functioning in humans. The redundant signal effect (RSE) refers to the observation that individuals respond more quickly to stimuli when information is presented as multisensory, redundant stimuli rather than as a single stimulus presented to either modality alone. Our studies show that the disinhibiting effects of alcohol are attenuated when stop signals are multisensory versus unisensory. The present study expanded on this research to test the degree to which multisensory stop signals could also attenuate the disinhibiting effects of alcohol in those with attention-deficit hyperactivity disorder (ADHD), a clinical population characterized by poor impulse control. The study compared young adults with ADHD with healthy controls and examined the acute impairing effect of alcohol on response inhibition to stop signals that were presented as a unisensory stimulus or a multisensory stimulus. For controls, results showed alcohol impaired response inhibition to unisensory stop signals but not to multisensory stop signals. Response inhibition of those with ADHD was impaired by alcohol regardless of whether stop signals were unisensory or multisensory. The failure of multisensory stimuli to attenuate alcohol impairment in those with ADHD highlights a specific vulnerability that could account for heightened sensitivity to the disruptive effects of alcohol.